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News

Peginterferon alfa-2a for hep C after liver transplantation

Peginterferon alfa-2a treatment for 48 weeks is safe and tolerable and offers some efficacy in the post-OLT setting, reports the February's issue of Hepatology.

News image

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There is currently no effective treatment for recurrent hepatitis C after orthotopic liver transplantation (OLT).

Dr Chalasani and colleagues performed 2 randomized, controlled trials - a prophylaxis trial and a treatment trial – in order to evaluate the safety and efficacy of peginterferon alfa-2a in patients who had undergone orthotopic liver transplantation.

The prophylaxis trial enrolled 54 patients within 3 weeks after OLT, and the treatment trial enrolled 67 patients 6 to 60 months after OLT.

In each trial, patients were randomized to treatment with once weekly injections of 180 g peginterferon alfa-2a or no antiviral treatment for 48 weeks and were followed up for 24 weeks thereafter.

Peginterferon alfa-2a treated patients had significantly lower hepatitis C virus RNA levels and more favorable changes in hepatic histological features compared with untreated controls.

Incidence of acute rejection was similar in the treated and untreated groups in both the prophylaxis and treatment trials
Hepatology

However, only 2 treated patients in the prophylaxis trial (8%) and 3 in the treatment trial (12%) achieved a sustained virological response.

In the prophylaxis trial, 8 patients (31%) in the peginterferon alfa-2a group and 9 (32%) in the untreated group were withdrawn prematurely; whereas in the treatment trial, 10 patients (30%) in the peginterferon alfa-2a group and 6 (19%) in the untreated group were withdrawn prematurely.

The incidence of acute rejection was similar in the treated and untreated groups in both the prophylaxis (12% vs. 21%) and treatment (12% vs. 0%) trials.

Dr Chalasani concluded, "Peginterferon alfa-2a treatment for 48 weeks is safe and tolerable and offers some efficacy in the post-OLT setting."

"Randomized controlled studies are needed to establish the efficacy of pegylated interferon and ribavirin in patients who have undergone OLT."

Hepatology; 2005: 41 (2): 289 - 98
21 January 2005

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